Wiki Anthem hospital video visit denial

[elizabeth.keipe@thedacare.org]

Has anyone had denials from Anthem on hospital video visits? There policy says they want POS 02 with a GT modifier but they denied it. They will not tell us which modifier they want.

 

[thomas7331]

What CPT/HCPCS did you bill and what did the denial say? Hospital telehealth services have their own codes, so it may be an issue with the code used rather than the POS or modifier.

 

[elizabeth.keipe@thedacare.org]

It was an initial observation visit billed with 99220 POS 02 & GT mod-dos was 2022. Denial was PX inconsistent w/mod & should be billed with appropriate code for service. So we should have used one of the telehealth G codes? We also had an inpt G0426 denied by UHC Medicare with mod 95 with POS 21. That was denied for invalid POS. Very confusing especially when the payer won't tell you what they want.